Overview
Please check the applicable tabs below to confirm what edits can or cannot be made to prior-authorization requests for members with specific insurance providers. The information in the "How to edit, withdraw, print" accordion is meant to show how to complete these actions and may not be available for some authorizations.
Please note that no edits can be made to referral requests.
How to edit, withdraw, print, and upload clinical documents
How to Edit & Withdraw
From the patient summary, you will be able to view a comprehensive list of previously submitted authorizations in the Cohere portal, including those created by other users at your organization and other organizations, when applicable.
After signing in, you will land on the Cohere prior authorizations dashboard. From here, navigate to the patient summary by clicking on a specific authorization (use the available filters to find the authorization you’re looking for).
Once in the patient summary, you will be able to view all of the previously submitted requests for this specific patient.
The authorization you clicked from the dashboard will be displayed in full detail in the patient summary. You can toggle more or fewer details using the “^” button.
To make edits or to withdraw a request, click the "Edit” button. The request form will populate on your screen.
In addition to the fields in the request, you also have the ability to edit attachments and clinical assessment questions (see more details about clinical attachments below). If you do make any changes, be sure to click “save” before exiting. In these situations, saving is the same as submitting.
How to Print
You have the ability to print authorizations from either the dashboard or the patient summary.
If you wish to print from the dashboard, locate the correct authorization, hover over the status bar, and click the printer icon. This will only appear for approved requests.
To print a service summary from the patient summary, navigate to this screen by following the instructions above. Once you are on the patient summary, click on the three dots next to the “^” button. Then, click the “Print” button to view the service summary and either download or print.
Uploading Clinical Documentation After Initial Submission
As mentioned previously, you are able to update clinical attachments after submission in some cases (dependent on payer policies, authorization status, etc.). Please note, allowable edits depend on the payer of the patient you are submitting for. Please view the tabs below for more information on which edits are allowed for each payer for each authorization status.
You may need to upload attachments after submission after receiving outreach for missing information or if you didn’t upload it during your initial submission. To do this, follow these steps:
Choose the file from your computer.
100MB is the maximum file size that is accepted
The following file types are supported: ".jpeg", ".jpg", ".pdf", ".rtf", ".tif", ".tiff"
You should be able to see all attachments that have been uploaded. You can see the dates, times, and the user who uploaded each attachment. Click “Save” before exiting.
Avera
BlueCross BlueShield of South Carolina
Once a prior authorization has been submitted in the Cohere portal, no edits are allowed, except for uploading additional clinical attachments related to continue care requests. If any aspect of the original request needs to be modified (e.g., changing a provider, adjusting the start date, etc.), please fax the necessary changes directly to Blue Cross Blue Shield of South Carolina or call the prior auth number on the back of the members ID card.
BlueCross BlueShield of Tennessee
Geisinger
HealthPartners
Humana
Editing authorizations claims information:
If you are adding new codes and/or units to your authorization request, and you have not submitted a claim yet, please include the new codes and/or units in your claim submission. If you are adding new codes and/or units to your request and you have already submitted a claim, please submit a new claim to ensure they are paid properly.
Medical Mutual (MMO)
Edits to prior authorization requests are not permitted after an request has been submitted, with the exception of clinical attachments. Additionally, withdrawal of a request may only take place before an authorization has been decisioned.